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目的 对 4 6例SARS患者 2 0 6份粪便及漱口液标本 ,检测SARSCoV ,探讨SARS患者恢复期排毒的情况。方法 对住院的 4 6例临床确诊SARS病人 ,留取粪便及同期漱口液各 10 3份 ,提取RNA后利用 14对SARSCoV特异性引物 ,对每份标本同时进行 7次套式RT PCR扩增 ,凡 1次RT PCR结果阳性 ,该标本即判定为阳性。结果 10 3份粪便标本中 ,6 3份 (6 1.2 % )SARSCoV阴性 ,4 0份(38.8% )阳性 ,阳性者的病程为 30 .75d± 11.2 7d(12d～ 6 4d)。 10 3份漱口液标本中 ,81份 (78.6 % )阴性 ,2 2份 (2 1.4 % )阳性 ,阳性者的病程为 2 9.82d± 12 .4 6d(12d～ 6 4d)。病程最长 6 4d时粪便及漱口液中依然发现SARSCoV病原学依据。患者同期粪便及漱口液RT PCR检测结果一致的有 6 1份(5 9.2 % ) ,不一致的有 4 2份 (40 .8% )。结论 SARS患者恢复期排毒可长达 6 4d ,对SARS患者恢复期的消毒隔离应该得到足够的重视。SARS患者粪便SARSCoVRNA阳性 ,而同期漱口液SARSCoVRNA阴性 ,提示SARSCoV可以直接经消化道传播。
Objective To investigate the detection of SARSCoV in 206 cases of stool and mouthwash from 46 cases of SARS patients and explore the detoxification during the convalescent phase of SARS. Methods Forty-six pairs of SARSCoV-specific primers were extracted from the hospitalized 46 cases of clinically diagnosed SARS patients with feces and synchronous mouthwash respectively. Seven sets of RT-PCR were performed on each specimen simultaneously , Where a RT PCR result is positive, the specimen is judged as positive. Results Of the 103 stool samples, 63 (6 1.2%) were negative for SARSCoV and 40 (38.8%) were positive for the stool samples. The duration of positive cases was 30 .75 ± 11.27 days (12 days to 64 days). 81 (78.6%) were negative and 22 (2.14%) were positive in 10 out of 3 samples of mouthwash. The course of the positive samples was 2 9.82 ± 12.46 days (12 days to 64 days). The course of up to 6 4d stool and mouthwash still found SARSCoV etiological basis. 61 1 (5.29%) were consistent with the RT PCR results of feces and mouthwash during the same period, 42 (40.8%) were inconsistent. Conclusion During the convalescent phase of SARS, the detoxification can last up to 64 days, and enough attention should be paid to the disinfection and isolation during the convalescence of SARS patients. SARS patients stool SARSVVRNA positive, while the mouthwash SARSoVRNA negative, suggesting that SARSCoV can be transmitted directly through the digestive tract.